Trigger Finger (Stenosing Flexor Tenosynovitis)

Catherine Burt Driver, MD

Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What Causes Trigger Finger?

Trigger finger is caused by inflammation of the tendon that bends the finger (flexor tendon). The inflammation causes swelling of the tendon and sometimes scarring with a nodule or lump on the tendon. The tendon then is too thick to slide easily in the tendon sheath and it sticks. This can cause snapping as the tendon is forced through the tendon sheath when the finger is bent and extended to straighten. A rare complication of severe trigger finger is the finger becoming stuck in a fixed bent position.

What Are Risk Factors for Trigger Finger?

Risk factors for trigger finger include the following:

Activities that cause pressure across the joints at the top of the palm of the hand, such as tight gripping and grasping and operating vibrating machinery

tenderness, or a nodule (bump) in the palm of the hand at the base of the affected finger;

popping, snapping, or clicking as the finger bends and straightens;

inability to fully flex the finger;

severe trigger finger can cause the affected finger to lock in a fixed, flexed position, requiring the use of the opposite hand to pull it straight.

What Tests Do Health-Care Professionals Use to Diagnose Trigger Finger?

The diagnosis of trigger finger is made on the basis of the symptoms of pain and sticking of the finger and by examination of the hand. X-rays are not necessary to diagnose trigger finger but may be used to exclude other conditions that cause hand pain.

What Are Treatments and Medications for Trigger Finger?

With mild trigger finger, resting the finger may be the only treatment needed. Gentle massage, stretching of the finger, followed by cold application can often relieve mild trigger finger. For more rapid relief, an injection of corticosteroids (cortisone), such as methylprednisolone (Depo-Medrol), is administered into the tendon sheath to reduce the swelling and inflammation. A single corticosteroid injection for trigger finger relieves symptoms up to 85% of the time. If the injection is ineffective, another injection may be given three to six weeks later.

If the corticosteroid injections are ineffective, then surgery to open the constricted tendon area may be necessary. Surgical repair procedure for trigger finger is referred to as a trigger finger release. This operation is performed by a specialist such as an orthopedic surgeon or orthopedic hand surgeon.

What Are Home Remedies for Trigger Finger?

Rest, cold application, and splinting may be helpful for mild trigger finger. Gently massaging a nodule at the base of the finger may help break up the scar tissue and relieve the pain. For more severe trigger finger, an injection around the affected area will usually bring relief. Exercises may worsen the problem by increasing inflammation.

NSAIDs (nonsteroidal anti-inflammatory medications such as ibuprofen [Advil) and naproxen sodium (Aleve, Naprosyn)] can be helpful for pain but are unlikely to resolve the underlying problem.

What Is the Prognosis of Trigger Finger?

With treatment, the prognosis of trigger finger is very good. Available treatments for trigger finger are very effective at relieving the problem. However, trigger finger may recur after corticosteroid (cortisone) injection and require further treatment.

Is It Possible to Prevent Trigger Finger?

One can prevent trigger finger by limiting repetitive movements and excessive pressure on the tendons in the hand. If the finger is rested when the symptoms are mild, the condition may improve and resolve rather than progressing.

Health Solutions From Our Sponsors

Tendinitis Causes

The most common cause of tendinitis is overuse and repetitive motion from recreational, athletic, or occupational activities. Risk factors for tendonitis include repetitive movement, trauma, thermal injury to the tendon, use of certain antibiotics (such as levofloxacin and ciprofloxacin), and smoking. Tendinitis can also occur in people with diseases such as rheumatoid arthritis, obesity, and diabetes.